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Disproportional exaggerated aspartate transaminase is a useful prognostic parameter in late leptospirosis

查看全文 作　　者：Ming-Ling [1]Chang;Chih-Wei [2]Yang;Jeng-Chang [3]Chen;Yu-Pin [1]Ho;Ming-Jeng [4]Pan;Cheng-Hui [1]Lin;Deng-Yn [1]Lin 高影响力作者 机构地区：[1]Department of Hepatogastroenterology, Chang Gung MemorialHospital, 5 Fu-Shin Street, Kweishan, Taoyuan, Taiwan, China;[2]Department of Nephrology, chang Gung MemorialHospital, Taoyuan, Taiwan, China;[3]Department of Surgery, Chang Gung MemorialHospital, Taoyuan, Taiwan, China;[4]National Taiwan University, Taipei, Taiwan, China Supported by the Chang Gung Medical Research Project fund,No. CMRPG 33014高影响力机构 出　　处：《World Journal of Gastroenterology》索引2005年第11卷第35期,共4页高影响力期刊 基　　金：Supported by the Chang Gung Medical Research Project fund, No. CMRPG 33014 摘　　要：AIM: To evaluate the hepatic dysfunction in leptospirosis is usually mild and resolved eventually. However,sequential follow-up of liver biochemical data remained lacking..METHODS: The biochemistry data and clinical symptoms of 11 sporadic patients were collected and analyzed, focusing on the impacts of leptospirosis upon liver biochemistry tests.RESULTS: The results disclosed that of the 11 cases, 5 or 45% died. The liver biochemistry data in the beginning of the disease course were only mildly elevated.Nevertheless, late exaggerated aspartate transaminase (AST)elevations were noted in three cases who finally died when compared with the typical course. Besides, significant higher AST/alanine transaminase (ALT) ratios (AARs) of the peak levels for transaminase were also noted in the cases who eventually succumbed. The mean±SD of AARs for the survival group and dead group were 5.65±2.27 (n = 5)and 1.86±0.64 (n = 6) respectively (P= 0.006). The ratios of the cases who finally died were all more than 3.0.Conversely, the survival group's ratios were less than 3.0.CONCLUSION: Serial follow-up of transaminase might provide evidence to predict some rare evolutions in leptospirosis. If AST elevated progressively without a concomitant change of ALT, it might indicate an acute disease course with ensuing death. Additionally, AAR is another prognostic parameter for leptospirosis. Once the value was higher than 3.0, a grave prognosis is inevitable. 关 键 词：天门冬氨酸转氨酶 细螺旋体病 病理机制 临床表现
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